- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,774.10 / $16,684.00 / $27,118.50
| Facility | | $9,774.10 | $16,684.00 | $27,118.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,140.29 / $15,057.36 / $18,926.30
| Facility | | $10,140.29 | $15,057.36 | $18,926.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,381.24 / $13,256.28 / $20,913.06
| Facility | | $8,381.24 | $13,256.28 | $20,913.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,263.06 / $11,557.62 / $22,512.46
| Facility | | $6,263.06 | $11,557.62 | $22,512.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,289.00 / $14,039.17 / $19,044.70
| Facility | | $6,289.00 | $14,039.17 | $19,044.70 |